Thursday, April 22, 2010

Seven days of trekking has brought us from the hot lowlands of the Makalu district at 600 meters through rainforest, cloud forest thick with rhododendron in bloom, on up through the subalpine, and finally into the glaciated high alpine region of Makalu Base Camp at 5000 meters. We are psyched to be here!

Our team is healthy and in great spirits, though the day before we learned that one of our advance kitchen staff dropping off supplies at Advance Base Camp (ABC) was being heli-evac'd with pneumonia as a chopper overflew us in the lower Barun Valley. He is now doing well back in Kathmandu.

We are resting today, allowing our bodies to engage in the physiologic process of acclimatization. Lots of changes are taking place in the days and weeks spent at altitude. The rate and depth of breathing increases, the kidneys increase their excretion of bicarbonate ion which slightly acidifies the blood, stimulating respiration. The bone marrow is prompted to start cranking out more oxygen-carrying red blood cells. Blood flow to the brain and lungs rises enormously.

Tomorrow we will make our way up to ABC at 5600m. It's important not to go too high too fast. The symtoms of Acute Mountain Sickness (headache, poor apetite, difficulty sleeping, shortness of breath) are early warning signs that it's time to rest or even descend. If ignored, they can quickly lead to the serious complications of High Altitude Pulmonary Edema(HAPE) or High Altitude Cerebral Edema(HACE). So far, only mild headache has been experienced by a few of our members.

As physician for the team, there have been daily medical and minor surgical issues I've encountered within our team, the porter staff, and villagers without access to medical care. I'm grateful to Adventure Medical Kits for their generous equipment support.

This afternoon we've been playing on the slackline(fortunately no injuries!), and tonight we're invited to the Ukrainian camp for some social time and to check out their sauna which they are firing up. Namaste all!